34 hospitals in state get Medicaid bonus
Posted on Wednesday, August 13, 2008
Arkansas Medicaid paid nearly $ 4. 9 million to 34 hospitals that reached certain quality measures for treating pneumonia and heart failure for the fiscal year that ended June 30, according to the state’s Department of Human Services.
The “bonus payments” were made as part of Medicaid’s voluntary Inpatient Quality Incentive Program, the department said Monday. The total sum given out was up from $ 3. 9 million for 29 hospitals last fiscal year, the first year of the program.
Seven criteria were used for evaluation.
On pneumonia, hospitals were evaluated on steps such as giving vaccinations, adult smoking-cessation counseling and providing antibiotics in a timely way. On heart failure, the hospitals were evaluated on instructions to discharged patients, smoking-cessation counseling, evaluating the left side of patients’ hearts, and whether patients were given certain medicines that improve outcomes.
St. Vincent Infirmary Medical Center in Little Rock received the largest payment for the fiscal year, at $ 567, 250.
Much of the payment is determined by the number of Medicaid discharges a facility has.
That number is used in a formula that multiplies the discharges by a dollar value that shows how well each facility did on its quality measures. A hospital can receive up to $ 50 per day for every discharge.
Jon Timmis, a vice president and chief strategy officer for St. Vincent, said the hospital has several motivations for meeting the quality measurements.
“In a world of increased transparency, just the recognition itself certainly stands alone in having merit,” he said. “But the financial reward is certainly a bonus to the recognition.” Although the payments are dwarfed by hospitals’ budgets, research shows that extremely large payments aren’t required to improve hospital practices, said Glen Mays, an associate professor at the University of Arkansas for Medical Sciences who has studied hospital competition.
More important, Mays said, is probably the signal the program is sending, “that quality is important, and we’re paying attention to it and measuring it, and we’re going to reward you on performance.” Research, Mays said, generally has shown that patients don’t pay much attention to such quality measures. Research also has shown that hospitals are partly motivated to meet them because of public reporting requirements, he said.
“[Hospitals ] don’t want to look bad in front of their peers around the state, so that’s another mechanism through which these incentives influence behavior,” Mays said.
Timmis said he hasn’t seen evidence to date showing that patients were choosing St. Vincent because of the Medicaid measurements, but he expects patients to evaluate hospitals on quality comparisons more in the future.
The Medicaid payments further a nationwide and statewide trend toward hospital transparency on quality, and quality-based payment. Recent examples include an Arkansas Hospital Association-funded site — www. hospitalconsumerassist. com, begun in late 2006 — and a $ 1. 9 million newspaper ad campaign this spring by the U. S. Centers for Medicaid and Medicare Services designed at increasing use of its own site, www. hospitalcompare. hhs. gov.
Some hospitals that weren’t eligible for the payments participated in the program anyway. Eight such hospitals were recognized for making improvements similar to those that received bonus payments: Baptist Medical Center in Arkadelphia; Bradley County Medical Center; DeWitt City Hospital; Cross-Ridge Community Hospital; Ozark Health Medical Center; McGehee-Desha County Hospital; South Mississippi County Regional Medical Center; and St. John’s Hospital-Berryville.
Those hospitals “are criticalaccess hospitals, which serve underserved areas, and they’re already getting the full benefit from Medicaid, the full payment, so they’re not eligible for the payments,” said Julie Munsell, spokesman for the state Department of Human Services.
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